GI Flashcards
ERCP used to dx what
Diseases of bile ducts: stones, strictures, leaks from trauma and surgery, and cancer.
Anesthetic consid for heartburn pts
Aspiration risk/RSI. Abx, NGT, NV post op, pain management
Nissan fundoplication: indication, methods
For heart burn. General anes, open or laparoscopic. 5 small incisions, one used for endoscope, other 4 to retract and manipulate
Obesity main concerns
Positioning, airway, aspiration, roux en y
What roux en y procedure does
Gastric bypass, creates a stomach pouch out of small pt of stomach, attaches directly to SI, bypasses stomach and duodenum. Laparoscopic approach
Achalasia anesthetic implic
Risk of aspiration. Pre induction decompression
Anesthesia consid for pt w esophagitis and hiatal hernia
Prevent pna and aspiration, RSI, pre meds to dec gastric contents/acidity, OGT, awake extubation
PUD anesthetic implic
H2 antagonists may inhibit p450. NG suctioning. RSI
Anesthesia consid for pt w IBD
Fluid and lyte management, avoid N20, supplemental steroids as indicated, anticholinesterase increases intraluminal pressure
Carcinoid tumor anesthesia management
Continue ocreotide- interferes w insulin release and exac DM. Catecholamines release serotonin (avoid them). Bronchospasm and hypotension tx- ocreotide 100-200 mcg IV. Avoid sympathomimetic agents. Tx htn w labetolol
Carcinoid syndrome- drugs to avoid
Histamine releasing drugs, ketamine, epi/catecholamines
Consid w GI bleed
H+h, volume status, bp fluctuations, esophageal varicies bleed
Appendicitis consid
May need RSI, abx, avoid n20
Anesthesia for bowel obstruc
No reglan. No n20. RSI. Albumin. Volume replacement. Lytes. Place OGT
Anesthesia consid for pt with cholecystitis
Inc intra abd p, interferes w ventilation. Reverse trendelenberg helps. Impacts venous return. Place og. End tidal co2 inc. tx oddi spasm (caused by opioids) w narcan/glucagon/ntg.
